A recent study by Mount Sinai Health System researchers published in Science Advances discovered that the blood thinner drug clopidogrel is more potent in reducing the formation of blood clots than aspirin among those living with HIV.
Juan Badimon, professor of cardiology and director of the Atherothrombosis Research Unit at the Cardiovascular Institute at Mount Sinai; Dr. Judith Aberg, the Dr. George Baehr Professor of Medicine and Infectious Disease and chief of the Division of Infectious Diseases at Mount Sinai’s Icahn School of Medicine; and Mohammad Urooj Zafar, a clinical researcher at the medical school, investigated the anti-inflammatory and antiplatelet effects (the ability to prevent blood clots from forming) of two of the most commonly used antiplatelet drugs, aspirin and clopidogrel, in people living with HIV.
Despite wide use of antiretroviral therapy and improved quality of life, people living with HIV remain at risk of earlier onset of age-related comorbities. Studies also show that poz folks suffer higher rates of cardiovascular events like heart failure, stroke, and heart attacks.
What the studies don’t show, however, is why that is. While doctors have long recommended aspirin therapy for those at high risk of heart problems, these findings indicate that clopidogrel is more effective for those with HIV.
“Clopidogrel not only has a more potent antithrombotic activity but also a significant anti-inflammatory effect as compared with aspirin in HIV patients,” Badimon explained when the findings were announced. (Antithrombotics prevent the formation of or treat blood clots within a blood vessel.)
As people with HIV live longer and cardiovascular issues continue to surpass AIDS-related complications as a leading cause of death, this finding could make a significant impact in reducing those deaths.
The study also found that inflammatory and immune activation markers—in addition to a higher propensity to develop blood clots—could be contributing to the higher cardiovascular disease rates among HIV-positive people.
“These results suggest that thrombus formation may be a contributing factor to the increased incidence of cardiovascular events reported among persons with HIV,” said Aberg.
These preliminary observations indicate a larger clinical trial could be warranted.